Application for Veterinary Assistance Grant

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Application Instructions

Thank you for your interest in applying for a Veterinary Assistance Grant from the Banfield Foundation. This grant program is to support programs of non-profit and governmental agencies that assist vulnerable community members with veterinary care for pets (small animals only - equine assistance programs are not eligible). You may request up to $10,000 in funding. Funding can be used for any type of veterinary care except routine spay and neuter.

Please be prepared to provide the following attachments:

A narrative including the goals and activities of your program, geographic reach, budgetary concerns, and plan for evaluation of program success.

Program budget.

Screening criteria and expense tracking plan.

IRS 501(c)(3) determination letter.

Previously funded applicants by the Banfield Foundation or
Banfield Charitable Trust must include their most recent final report and expense
tracking or their application will be considered incomplete.

Organizations can only be approved for funding for two consecutive years for the Veterinary Assistance and/or Pet Advocacy Grant programs. If you have been funded by the Banfield Foundation and/or Banfield Charitable Trust for the last two years, you will not be considered for a third year of funding. After a gap year, you will, however, be able to apply for either grant program again.

We strongly encourage you to compress all attached files in zip folders or at a free online resource such as smallpdf.com. You may save this application at any time to complete later. Veterinary Assistance Grant applications are reviewed on a monthly basis, and may be eligible for funding up to six months after the application is received.

Organizations can only be approved for funding once a year, and for a total of two consecutive years, for the Veterinary Assistance, Veterinary Medical Equipment and/or Pet Advocacy Grant programs. If you have been funded by the Banfield Foundation and/or Banfield Charitable Trust for the last two years for these programs, you will not be considered for a third year of funding. After a gap year, you will, however, be able to apply for these grant programs again. This rule does not apply to our Disaster Relief and Flea and Tick Grant programs. If you have any questions on whether your organization is eligible, or any questions related to grant applications, please don’t hesitate to email Darlene at darlene.schwartz@banfieldfoundation.org.

Please note, due to the volume of requests for this program, we have initiated a new grant review process. All applications will be kept in the review pipeline for 90 days from the submission date. If the application is not funded at the end of 90 days, it willexpire and automatically be denied. Unless your program does not meet our eligibility guidelines, the denial is not a reflection of your organization, your program or the quality of your application as it is a reflection of the competitive nature of our program and the volume of applications received. If your program meets eligibility guidelines and is not awarded a grant, we encourage you to apply again. Please reach out with any questions or if you need clarification on our grant review process.

Primary Contact Person

First Name

Last Name

Email

Title

Contact Phone

Contact Phone Extension

Would you like to list a secondary contact person?

YesNo

Secondary Contact

Secondary Contact First Name

Secondary Contact Last Name

Secondary Contact Email

Secondary Contact Title

Secondary Contact Phone

Secondary Contact Phone Extension

Organization Information

Organization Name

Organization EIN

If you are a governmental organization and do not have an EIN, please email info@banfieldfoundation.org for instructions

To select multiple states, hold down the Ctrl or Cmd key while clicking each state you wish to select.

Specific counties or information about locations served - 255 character limit

Has your organization received prior funding from the Banfield Foundation or the Banfield Charitable Trust?

YesNo

Funding History with Banfield Foundation

List the date and grant amount your organization has received from Banfield Foundation or Banfield Charitable Trust. If there is more than one response please select the 'Add Another Response' button.

Program Name

Amount

Date

Please attach your final report as submitted for the most recent grant.

All files attached to this application must total less than 20 MB. Please compress your files at a free resource such as smallpdf.com.

Narrative

Briefly describe your organization and how your program will work. Please be sure to incorporate the following:

General information about your organization, your various programs and the need for this veterinary assistance program

Describe program's goals and activities involved in this request.

Estimate the number of pets or people that will be helped and geographic reach of your program.

Describe your program in detail and include answers to the following questions:a) Will funds be used for emergency care, preventive care, basic veterinary care or can recipients use them for any type of care?b) What is the maximum award amount?c) Is client required to contribute to pet's care? How much or what percentage?d) Is client required to apply for CareCredit?e) Do you deliver services directly or do you work with veterinary partners?f) If using veterinary partners, please list them or state 'Open to All'g) Do your veterinary partners provide a discount to your organization?h) How do you market your program to local veterinary practices?

Describe your plan for evaluating the success of your project.

In your last full year of operation, what percentage of the funds you raised went directly to support programs? If you have been in existence less than a year, what percentage of the funds raised do you expect to go directly to support pets?

All files attached to this application must total less than 20 MB. Please compress your PDF files at a free resource such as smallpdf.com.

Program Budget

Please attach a program budget. PLEASE NOTE: Funds from this grant must be used for veterinary care expenses only including exams, routine tests, procedures/surgeries, medications, vaccinations, preventive case, etc. You cannot use the grant to cover overhead, office expenses, marketing, fundraising, or other indirect costs, or to fund routine spay/neuter.

All files attached to this application must total less than 20 MB. Please compress your files at a free resource such as smallpdf.com

Screening Criteria and Expense Tracking

Attach an in-depth explanation covering how you qualify or screen recipients for need. Please include veterinary assistance application form if you have one. In your explanation, be sure to include answers to the following questions:

Does your program require photo ID as proof of identity?

Which of the following entitlement programs or situations qualify for assistance from your program?a) State or federally funded welfare programb) Food Stampsc) Medicaid d) Social Securitye) SSI Disabilityf) Unemploymentg) Non-commissioned active militaryh) Extreme medical expense, loss of home due to natural disaster, etc. i) Pay Stub proving income meets state or federal low income or WIC guidelines

Include a complete description of how you plan to track the funds you spend. You will be required to submit a year-end report describing how you spent the funds, including a detailed expense log. Banfield Foundation can furnish you with an Excel spreadsheet to enable easy tracking of all grant funding expenditures.

All files attached to this application must total less than 20 MB. Please compress your PDF files at a free resource such as smallpdf.com

IRS 501(c)(3) Determination Letter

If you are a governmental organization and not a 501(c)(3) please email info@banfieldfoundation.org for instructions.

Other Attachments

If you have any other attachments that you would like to add please attachment (e.g. program brochures, news and PR, other comments, or photos) please attach them below. If you have more than one please select 'Add another response.'

All files attached to this application must total less than 20 MB. Please compress your files at a free resource such as smallpdf.com